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Yield of gastric lavage and bronchial wash in pulmonary tuberculosis
1Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. rizvi_tasneem@lilly.com
Objective:
To determine the yield of acid-fast bacilli (AFB) in gastric lavage and bronchial washing in adult patients clinically and radiologically suspected of pulmonary tuberculosis but who cannot produce sputum.
Methods:
Selected adult patients were admitted to the ward; gastric lavage was done for 3 consecutive days after an overnight fast followed by bronchial wash. Specimens were immediately sent to laboratory for AFB direct smear and culture.
Results:
The yield of AFB in gastric lavage on direct smear was 16/20 (80%) and 12/20 (60%) in the first and second samples, respectively. When combined, 18/20 (90%) were direct smear positive, while the third sample did not increase the yield. The yield of AFB culture in gastric lavage was 6/20 (30%) in both the first and second samples, while the combined results of the first and second samples were 8/20 (40%). The third sample did not increase the yield. In bronchial wash, AFB direct smear was positive in 18/20 (90%), while culture was positive in 14/20 (70%).
Conclusion:
Gastric lavage and bronchial washing are useful methods for the diagnosis of pulmonary tuberculosis in patients who cannot produce sputum. Two gastric lavage specimens are adequate. On comparison, bronchial wash is superior to gastric lavage in culture, but their yield on direct smear is equal.